SEED Follow-Up Study: Second Follow-up Survey of Young Adults (Self-Report)
C. Daily Activities and Social Participation 3
D. Vocational Support and Training 5
G. Health, Mental Health, & Health Care Service Use and Need 11
H. Educational & Developmental Services 14
I. Romantic Relationships, Sexual Orientation, and Gender Identity 15
J. Sex Education and Behavior 16
K. Substance Use and Behaviors 17
When did you graduate or leave school? (This includes traditional high school, homeschool, or another school program).
Month |
Year |
|
|
What was the highest grade level you completed when you left school? (Check 12th grade if you recently graduated high school)
❍ Pre-school |
❍ 7th grade |
❍ Kindergarten |
❍ 8th grade |
❍ 1st grade |
❍ 9th grade |
❍ 2nd grade |
❍ 10th grade |
❍ 3rd grade |
❍ 11th grade |
❍ 4th grade |
❍ 12th grade |
❍ 5th grade |
❍ Don’t know |
❍ 6th grade |
❍ Does not apply, I did not attend a typical public or private school |
❍ Other education, specify: _____________________________ (e.g., 18-21-year-old program for eligible high school students) |
When you left school, did you…
Receive a regular high school diploma
Receive an occupational diploma
Receive a certificate of completion
Take a test and receive a GED
Drop out or stop going
Get expelled (or suspended but did not return)
Other, specify: __________________________________
Since leaving school, have you attended a… (Check all that apply)
|
No |
Yes |
If yes, did you graduate with… |
No |
Yes |
2-year community college? |
|
|
a diploma, certificate, or license? |
|
|
vocational, business, or technical school? |
|
|
a diploma, certificate, or license?
|
|
|
4-year college? |
|
|
degree, certificate, or license? |
|
|
graduate program (e.g., master’s or doctoral program)? |
|
|
advanced degree (e.g., master’s or doctoral degree)
|
|
Are you currently enrolled in college?
No
Yes, Part-time
Yes, Full-time
Yes, but unsure whether part-time or full-time
Where do you currently live or what is your current living situation? (Check only one)
Independently (alone) with some assistance
Independently (alone) with no assistance
Independently (with spouse or roommate)
With parent(s) or foster parent(s)
With an adult family member who is not a parent (e.g., sibling, aunt, uncle, cousin, etc.) Specify relationship: ____________
With a legal guardian who is not a family member
In a group home within the community
In a residential facility separated from the community
Other (Specify, please print): ____________________________
The next questions are about activities you may have participated in since leaving school.
Since leaving school, have you participated in:
|
Yes |
No |
Don’t know |
A sports team or taken sport lessons? |
|
|
|
Any clubs or organizations? |
|
|
|
Any other organized activities or lessons, such as music, dance or language? |
|
|
|
Any type of community service or volunteer work at school, church, or in the community? |
|
|
|
Any work, including regular jobs as well as babysitting, cutting grass, or other occasional work? |
|
|
|
IN THE LAST 6 MONTHS, how often do you usually do the following:
|
Never |
At least once |
Every other month |
Monthly |
Weekly |
Daily |
Get together socially with friends or neighbors? |
|
|
|
|
|
|
Call or text friends on the phone? |
|
|
|
|
|
|
Use email, instant messaging, Skype, texting, Facebook/Instagram/Snapchat messaging or taken part in chat rooms? |
|
|
|
|
|
|
Gotten together with ANY relatives, not including those who live with you? |
|
|
|
|
|
|
Gone to church, temple, or another place of worship for services or other activities? |
|
|
|
|
|
|
Gone to a show or movie, sports events, club meeting, or another group event? |
|
|
|
|
|
|
Gone out to eat at a restaurant? |
|
|
|
|
|
|
DURING THE PAST MONTH, on how many days have you done a total of 30 minutes or more of physical activity, which was enough to raise your breathing rate? This may include sports, exercise, and brisk walking or cycling for recreation or to get to and from places but should not include housework or physical activity that may be part of your job.
Number of days of exercise during the past month: ____
ON AN AVERAGE WEEKDAY, about how much time do you usually spend in front of a TV watching TV programs or movies, including streaming services such as Netflix, Hulu, Apple+?
None
Less than 1 hour
1 hour
2 hours
3 hours
4 or more hours
I don’t know
ON AN AVERAGE WEEKDAY, about how much time do you usually spend with computers, tablets, cell phones, handheld video games, and other electronic devices, doing things other than schoolwork or watching videos on YouTube/TikTok, TV shows, or movies?
None
Less than 1 hour
1 hour
2 hours
3 hours
4 or more hours
I don’t know
The next questions are about services or training you may have received after leaving school to help you find and/or keep a job.
After you exited school, did you receive any of the following services? (Check all the apply)
|
Service |
Yes |
No |
Don’t know |
a. |
Testing to find out your work interests or abilities. |
|
|
|
b. |
Training in specific job skills, for example food services, computer skills, or training for another kind of job. |
|
|
|
c. |
Training in basic skills needed for work, like counting change, telling time, or using transportation to get to work. |
|
|
|
d. |
Career counseling, like help in figuring out jobs that might best suit you. |
|
|
|
e. |
Help in learning how to search for available job positions online, write a resume, or prepare for a job interview. |
|
|
|
f. |
Job shadowing, such as visiting a workplace and watching the way a job is done. |
|
|
|
g. |
Apprenticeships or internships. |
|
|
|
h. |
Other services or training? Specify: _____________________________ |
|
|
|
Do you think you need job training or additional training that is not being provided now?
Yes
No (Skip to Section E)
Don’t know (Skip to Section E)
Do you think you are getting enough job or career training?
Yes
No
Don’t know
How useful do you think job or career training is in helping you get a job?
Very useful
Somewhat useful
Not very useful
Not at all useful
Don’t know
What other kinds of job training or help do you think you need? (Check all that apply)
Testing to find out your work interests or abilities
Training in specific job skills, for example food services, computer skills, or training for another kind of job
Training in basic skills needed for work like counting change, telling time, or using transportation to get to work
Career counseling like help in figuring out jobs you might be suited to
Help in finding or applying for a job such as learning how to search for available job positions online, write a resume, or prepare for a job interview
Job shadowing, visiting a workplace and watching the way the job is done
Apprenticeships or internships
Other, specify: __________________________
Don’t know
The next questions are about work you were paid for since leaving school.
At any time since leaving school have you worked for pay other than work around the house?
Yes (Skip to question 3)
No
You have told us you are not currently working for pay. Please help us understand your situation.
Check all that apply then skip to Section F, Financial Support.
|
|
☐ |
Want to work but can't find work |
☐ |
Have tried to work but faced discrimination or other difficulties with employers because of a disability |
☐ |
Do not wish to work at present (taking care of family members, a stay-at-home parent, etc.) |
☐ |
Not able to work because it would interfere with federal or state benefits (such as disability payments) |
☐ |
Not able to work because the workplace would be too challenging (because of ASD or other health or mental health issues) |
☐ |
Have an unpaid internship or volunteer position |
☐ |
Full-time or part-time college student |
☐ |
Other (Specify:_____________________________________________________) |
What is the longest time you have worked at a particular job since leaving school?
For your current or most recent job, how many hours per week do/did you work on average?
1 - 9 hours
10 - 19 hours
20 - 29 hours
30 - 39 hours
40 or more hours
If you work(ed) part-time, or less than 40 hours per week at your current or most recent job, do you work part-time because you want to, or would you rather work full-time?
Does not apply, I work(ed) full time
I want to work part-time
I would rather work full-time
Other, specify __________________
For your current or most recent job, about how much are/were you paid per hour, per month, or per year at this job?
Did you receive benefits from this job? (Check all that apply)
Health Insurance
Vacation/Sick leave
Retirement account
Other insurance (e.g., disability, life, dental, vision)
Tuition assistance
Other, specify:
None
For your current or most recent job, what was the work situation? (Check one situation that best describes your current or most recent job)
|
☐ |
☐ |
Regular paid employment (with no help or support) |
☐ |
Supported employment (you may have a job coach or other special help at work) |
☐ |
Work in a business with a group of other people with special needs, all under supervision of an agency serving people with disabilities |
☐ |
Day program that includes paid work |
☐ |
Paid internship or work study program |
☐ |
Other, specify: ________________ |
How satisfied are you with the work situation at your current or most recent job?
Very satisfied
Satisfied
Neither satisfied nor dissatisfied
Dissatisfied
Very dissatisfied
For your current or most recent job, what is the job title?
Job Title: _____________________________________
Did you find your current or most recent job yourself or did you have help?
Found the job on my own
Found the job with help from an agency (e.g., a job coach or vocational rehab)
Found the job with help from a family member or friend?
Other, specify: _______________________________________________
Have you ever applied for any accommodations or supports to help you keep a job?
Yes, applied and received job accommodations and/or supports
Yes, applied but did NOT receive job accommodations and/or supports (Skip to Section F, Financial Support)
No, never applied for job accommodations or supports (Skip to Section F, Financial Support)
If you have ever received accommodations or supports to help maintain employment, how useful were these services?
Not useful at all (i.e., did not provide any additional advantage keeping job)
Slightly useful (i.e., helped a little for keeping job)
Useful (i.e., helped a good deal for keeping job)
Very useful (i.e., made the difference between keeping or losing a job)
How much do you rely on your family (such as parents and siblings) for financial support such as paying your bills, housing, transportation, spending money for entertainment, or other financial?
My family does not provide any financial support for me at all.
My family provides less than half of my financial support. They help me financially sometimes.
My family provides about half of my financial support.
My family provides more than half (but not all) of my financial support.
My family provides all my financial support.
What federal or state benefits do you currently receive? (Check all that apply or "none" if none apply)
Social Security Disability Insurance (SSDI) |
☐ |
Supplemental Security Income (SSI) |
☐ |
State disability programs that use only state and/or local funds |
☐ |
Medicaid (for health insurance) |
☐ |
Medicare |
☐ |
Medicaid HCBS (Home and Community Based Services) waiver or Developmental Disability waiver |
☐ |
Employment assistance or job support (sometimes called "Vocational Rehabilitation" or "VR") |
☐ |
Section 8 Housing |
☐ |
Transportation services for people with disabilities |
☐ |
Other, specify:________________________________________________________ |
☐ |
None |
☐ |
The next questions ask you for information about your mental health, suicide and sexual activity, along with other health care services you may have used or needed. You can skip any questions that make you feel uncomfortable. Your responses will be kept private and will not be shared with anyone.
Which of the following best describes your general health? Please mark ONE Box.
Excellent
Very good
Good
Fair
Poor
OVER THE LAST 2 WEEKS, how often have you been bothered by the following problems?
|
Not at all |
Several days |
More than half the days |
Nearly every day |
Feeling anxious, nervous, or on-edge.
|
|
|
|
|
Not being able to stop or control worrying.
|
|
|
|
|
OVER THE LAST 2 WEEKS, how often have you been bothered by the following problems?
|
Not at all |
Several days |
More than half the days |
Nearly every day |
Little interest or pleasure in doing things.
|
|
|
|
|
Feeling down, depressed, or hopeless
|
|
|
|
|
Have you ever seriously thought about committing suicide?
Yes
No
Have you ever made a plan for committing suicide?
Yes
No
Have you ever attempted suicide?
Yes
No
If you are having thoughts about suicide, please contact the National Suicide Prevention Lifeline by calling 1-800-273-8255 or texting 988
Since leaving school, was there any time when you needed health care, but you did not receive it? By health care, we mean medical care as well as other kinds of care like dental care, vision care, and mental health services.
Yes
No (Skip to question 10)
If yes, which types of care were NOT received? (Check ALL that apply)
Dental Care
Hearing Care
Medical care, routine preventative
Medical care, sick or urgent care
Medical care, hospital emergency
Medical care, specialist
Medical services for diagnosis or evaluation related to a disability
Mental Health Services, counseling, or psychological services
Vision Care
Other, Specify _________
Which of the following contributed to you not receiving needed health care services:
|
Yes |
No |
I did not have health insurance that covered the services needed |
|
|
I was not eligible for the services |
|
|
The services I needed were not available in my area |
|
|
There were problems getting an appointment when I needed one |
|
|
There were problems with getting transportation |
|
|
The (clinic/doctor’s) office wasn’t open when I needed care |
|
|
There were issues related to cost |
|
|
There were issues related to COVID-19 (e.g., concerned about being around others at doctor’s office who may have been exposed to COVID-19) |
|
|
Other (Specify:________________________) |
|
|
DURING THE PAST 12 MONTHS, have you had a chance to visit or speak with a doctor or other health care provider alone or privately, without your parents or another adult in the room?
Yes
No
During any visit in the past 12 months did a doctor or other health care provider ask you if you were sexually active?
Yes
No
Don’t remember
The next two questions are only for participants who were born female. If you were born male, skip to question 14.
DURING THE PAST 12 MONTHS, did you receive any of the following services from a doctor or health care provider?
Information or advice about birth control
A method of birth control or a prescription for birth control
Information or advice about other sexually transmitted diseases (STDs), such as gonorrhea, chlamydia, syphilis, herpes, HIV, AIDS, or HPV
Testing for STDs
Treatment for STDs
Information or advice about using condoms to prevent STDs
None of the above
Have you ever received:
A Pap test - where a doctor or nurse put an instrument in the vagina and took a sample to check for abnormal cells that could turn into cervical cancer?
An HPV test - where a doctor or nurse put an instrument in the vagina and took a sample to test for the HPV virus?
The cervical cancer vaccine, also known as the HPV shot, Cervarix, or Gardasil?
None of the above
The next question is for participants who were born male. If you were born female answer questions 12 and 13 then skip to Section H, Educational & Developmental Services
DURING THE PAST 12 MONTHS, did you receive any of the following services from a doctor or health care provider?
Information or advice about your partner using methods of birth control
Information or advice about HIV or AIDS
Information or advice about other sexually transmitted diseases (STDs), such as gonorrhea, chlamydia, syphilis, herpes or AIDS, HPV
Testing for STDs
Treatment for STDs
Information or advice about using condoms to prevent STDs
Information or advice about using condoms to prevent pregnancy
None of the above
The next questions are about educational and developmental services you may have received since leaving school.
Since leaving school, have you received any of the services listed in the table below? Do not include services/help received from family or friends.
|
Yes, received after leaving school |
No, did not receive after leaving school |
If no, did you need this service? |
Financial aid, like paying for college classes or training. |
☐ |
☐ |
☐ Yes ☐ No |
Educational assistance or tutoring. |
☐ |
☐ |
☐ Yes ☐ No |
Reader or interpreter, such as a sign language interpreter. |
☐ |
☐ |
☐ Yes ☐ No |
Independent living or occupational therapy (like help with doing things such as managing money, cooking, or housekeeping). |
☐ |
☐ |
☐ Yes ☐ No |
Childcare services or parenting skills training. |
☐ |
☐ |
☐ Yes ☐ No |
Social work services. |
☐ |
☐ |
☐ Yes ☐ No |
Physical therapy. |
☐ |
☐ |
☐ Yes ☐ No |
Devices or assistive technology services (like a special calculator, reading machine, or communication device). |
☐ |
☐ |
☐ Yes ☐ No |
Other services (Please specify):
|
☐ |
☐ |
☐ Yes ☐ No |
Overall, how satisfied have you been with all services you have received since leaving school?
Very dissatisfied
Dissatisfied
Neither satisfied nor dissatisfied
Satisfied
Very Satisfied
The next questions are about romantic relationships, sexual orientation, and gender identity. You can skip any questions that make you feel uncomfortable. Your responses will be kept private and will not be shared with anyone.
Do you consider yourself….
Male
Female
Non-binary
Other, please specify:______________________
Do you consider yourself transgender?
Yes, transgender, male-to-female
Yes, transgender, female-to-male
Yes, transgender, nonconforming
No
Don’t know
Which of the following best describes how you think of yourself?
Heterosexual or straight (attracted to people of the opposite sex)
Gay or lesbian (attracted to people of the same sex)
Bisexual (attracted to people of both sexes)
Pansexual (attracted to people of any gender identity regardless of their biological sex)
Asexual (not sexually attracted to other people)
I describe my sexual identity some other way
I am not sure about my sexual identity (questioning)
I do not know what this question is asking
Have you ever been in a relationship with a romantic partner?
Yes
No
Are you currently dating or in a relationship with a romantic partner?
Yes (Skip to Section J)
No
How much would you like to have a romantic relationship in the next year?
Not at all
Very little
Somewhat
Quite a bit
Very much
The next few questions are about your sexual education and behavior. You can skip any questions that make you feel uncomfortable. Your responses to these questions will be kept private and will not be shared with anyone.
Please tell me where you received formal sex education or any information on the following topics (check all that apply).
☐ |
School |
Church |
Community Center |
Doctor’s office |
Health Center |
Friends |
Parents/Family |
Online, Internet |
Never have received instruction or information on this topic |
|
How to say no to sex
|
☐ |
☐ |
☐ |
☐ |
☐ |
☐ |
☐ |
☐ |
☐ |
|
Methods of birth control
|
☐ |
☐ |
☐ |
☐ |
☐ |
☐ |
☐ |
☐ |
☐ |
|
Where to get birth control
|
☐ |
☐ |
☐ |
☐ |
☐ |
☐ |
☐ |
☐ |
☐ |
|
Sexually transmitted diseases (STDs)
|
☐ |
☐ |
☐ |
☐ |
☐ |
☐ |
☐ |
☐ |
☐ |
|
How to prevent HIV/AIDS
|
☐ |
☐ |
☐ |
☐ |
☐ |
☐ |
☐ |
☐ |
☐ |
|
How to use a condom
|
☐ |
☐ |
☐ |
☐ |
☐ |
☐ |
☐ |
☐ |
☐ |
|
Some other type of education or information
|
|
Please specify type of education/information and place received: |
Have you ever had sex, either with a same or opposite sex partner (this includes having oral, anal, or vaginal sex)?
Yes
No (Skip to question 13)
The last time you had sex with a partner, what method or methods did you or your partner use to prevent pregnancy and/or sexually transmitted diseases (STDs)? (Check all that apply)
No method was used to prevent pregnancy or STDs
Birth control pills (Do not count emergency contraception such as Plan B or the "morning after" pill.)
Condoms
An intrauterine device (IUD, such as Mirena or ParaGard) or implant (such as Implanon or Nexplanon)
A shot (such as Depo-Provera), patch (such as Ortho Evra), or birth control ring (such as NuvaRing)
Withdrawal
Some other method
Not sure
Did you drink alcohol or use drugs before you had sex the last time with any partner (same or opposite sex)?
Yes
No
How old were you when you had sex for the first time with any partner (same or opposite sex)?
Less than 15 years old
15 to 17 years old
18 years old or older
DURING THE LAST 12 MONTHS, with how many people did you have sex (same or opposite sex)?
I have had sex, but not during the past 12 months
1 person
2 to 3 people
4 or more people
Has anyone ever forced you to do sexual things that you did not want to do? Examples might include unwanted kissing or touching, physical pressure (being hit, slammed into something, or injured with an object or weapon) or non-physical pressure (verbal pressure, threats of harm, or by being given alcohol or drugs)
Yes
No
Prefer not to say
Please contact the National Sexual Assault Hotline by calling 800-656-4673 if you are experiencing sexual assault or sexual harassment.
The next questions asks about substance use. You can skip any questions that make you feel uncomfortable. Your responses to these questions will be kept private and will not be shared with anyone.
Think about the statement, “I did too much.” IN THE LAST 12 MONTHS, how often did this apply to your…
☐ |
None of the time |
A little of the time |
Some of the time |
Most of the time |
All of the time |
Never used or N/A |
Alcohol use |
☐ |
☐ |
☐ |
☐ |
☐ |
☐ |
Tobacco or Nicotine use |
☐ |
☐ |
☐ |
☐ |
☐ |
☐ |
Cannabis/marijuana use |
☐ |
☐ |
☐ |
☐ |
☐ |
☐ |
Cocaine use |
☐ |
☐ |
☐ |
☐ |
☐ |
☐ |
Opioid use |
☐ |
☐ |
☐ |
☐ |
☐ |
☐ |
Gambling |
☐ |
☐ |
☐ |
☐ |
☐ |
☐ |
Shopping |
☐ |
☐ |
☐ |
☐ |
☐ |
☐ |
Video gaming |
☐ |
☐ |
☐ |
☐ |
☐ |
☐ |
Over-eating |
☐ |
☐ |
☐ |
☐ |
☐ |
☐ |
Sexual activity |
☐ |
☐ |
☐ |
☐ |
☐ |
☐ |
Over-working |
☐ |
☐ |
☐ |
☐ |
☐ |
☐ |
While some of these questions will use words such as “spirituality” please answer them in terms of your own personal belief system, whether it be religious, spiritual or personal.
|
Not at all |
A little |
A moderate amount |
A lot |
An extreme amount |
☐o what extent does any connection to a spiritual being or force help you to get through hard times?
|
☐ |
☐ |
☐ |
☐ |
☐ |
To what extent does any connection to a spiritual being or force help you to tolerate stress?
|
☐ |
☐ |
☐ |
☐ |
☐ |
To what extent does any connection to a spiritual being or force help you to understand others?
|
☐ |
☐ |
☐ |
☐ |
☐ |
To what extent does any connection to a spiritual being or force provide you with comfort / reassurance?
|
☐ |
☐ |
☐ |
☐ |
☐ |
What particular abilities or strengths do you have? Check all that apply or "none of the above" if none apply.
An ability to think in unusual, creative ways
An ability to focus intensely on certain topics
Honesty
A sense of justice
A different way of experiencing the world
Ability in mathematics, science, or computers
Ability in art or music
A very good memory for certain topics
An ability to focus on small details
An incredible imagination
Kindness
Other, specify: _____________________________________
None of the above
Do you have an intense area of interest or focus? (Sometimes this is referred to as a “special interest”)
No (Skip to end of survey)
Yes
What type of special interest or topic do you have? Check all that apply if you have more than one.
Modes of transportation (such as trains, automobiles, aircraft)
History
Science (such as astronomy, geology)
Science fiction or fantasy (in books, films, video games)
Computers
Mathematics or numbers
Animals (such as dogs, fish, horses)
Movies
Cartoons or anime
Maps, calendars, or dates
Timetables or schedules
Dinosaurs, monsters, or fictional creatures
Music
Art
Sports
Sewing or crafts
Other, specify: _______________________________
How does your special interest affect your life? Check all that apply or "none of the above" if none apply.
My job or career involves my special interest.
My studies in school or college are (or were) related to my special interest.
I have relationships based on my special interest. I make friends or join groups focused on the same interest.
I enjoy activities and hobbies relating to my special interest.
My special interest sometimes gets in the way of success at work, school, or in relationships.
The special interest has gotten me in trouble. (For example, it may have led to addictive behavior or breaking the law.)
Other, specify: _________________________________
None of the above
You have reached the end of the survey.
Thank you for participating!
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Powell, Patrick (CDC/DDNID/NCBDDD/DHDD) |
File Modified | 0000-00-00 |
File Created | 2023-07-29 |